| 摘要: |
| 目的探讨GeneXpertMTB/RIF系统对规范治疗疗效不佳肺结核患者的检测价值和预警价值。方法选取经规范治疗2个月痰结核杆菌（MTB）仍阳性的52例肺结核患者（实验组）和痰菌转阴的140例患者（对照组），采用GeneXpertMTB/RIF系统对痰液进行痰找MTB、利福平耐药基因检测，同时予以痰培养药敏试验。并比较两组患者GeneXpertMTB/RIF系统的MTB检出率及利福平耐药基因检出率，比较GeneXpertMTB/RIF系统检测结果与痰培养检测结果的差异。治疗至5个月末时，进一步对实验组的疗效与治疗2个月末时GeneXpertMTB/RIF系统的预测结果进行比较。结果GeneXpertMTB/RIF系统在实验组的MTB检出率达96.2%（50/52），利福平耐药基因检出率达94.3%（33/35）。对痰培养阳性、痰涂片阳性的MTB检出率为96.2%（50/52），痰培养阳性、痰涂片阴性的MTB检出率为50.0%（5/10）。实验组GeneXpertMTB/RIF系统检测与痰培养对利福平耐药结果相似，差异无统计学意义（字2=0.15，P＞0.05）。5个月末实验组临床治疗有效率25.0%（13/52），与GeneXpertMTB/RIF系统的预测有效率34.0%（17/50）相当，差异无统计学意义（字2=0.99，P＞0.05）。对照组临床治疗有效率82.1%（115/140），与GeneXpertMTB/RIF系统的预测有效率100.00%（5/5）相当，差异无统计学意义（字2=1.08，P＞0.05）。结论GeneXpertMTB/RIF系统对临床治疗不佳肺结核具有重要的检测和预警价值。 |
| 关键词: GeneXpert MTB/RIF 系统 利福平耐药基因 结核分枝杆菌 |
| DOI： |
| 分类号: |
| 基金项目:湖州市科技局项目（重点）（2014GZ10） |
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| Application of GeneXpert MTB/RIF testing for patients with smear-positive pulmonary tuberculosis after treatment |
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TONG Yong, ZHONG Jianfeng, Tong Zhaowei, SONG Qun, WANG Xinxia, WANG Weihong
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Huzhou Central Hospital
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| Abstract: |
| Objective To evaluate the application of GeneXpert MTB/RIF testing in patients with smear-positive pulmonary tuberculosis after treatment. Methods Fifty two pulmonary tuberculosis patients with positive smear at the end of 2 months of treatment (study group) and 140 patients with negative-smear after treatment(control group) were enrolled in the study. The GeneXpert MTB/RIF system was used to detect the mycobacterium tuberculosis and Rifampin (RFP)-resistance genes, and the results were compared with those of mycobacterium tuberculosis culture and drug sensitivity testing by chi-square. The detection rates of mycobacterium tuberculosis and rifampicin-resistance genes by GeneXpert MTB/RIF were compared between study group and control group. The consistency of GeneXpert MTB/RIF testing with mycobacterium tuberculosis culture and drug sensitivity test was analyzed. In study group, the therapeutic effect at the end of 5 months was compared to those at the end of 2 months as predicted by GeneXpert MTB/RIF testing. Results In study group, the positive rate of mycobacterium tuberculosis was 96.2%(50/52) and the positive rate of RFP-resistance gene was 94.3%(33/35). The rate of mycobacterium tuberculosis was 96.2% (50/52) by GeneXpert MTB/RIF for patients with positive culture and positive smear, while the rate of mycobacterium tuberculosis was 50.0% (5/10) for patients with positive culture and negative smear. In study group there was no significant
difference in RFP-resistance rate between the results detected by GeneXpert MTB/RIF and by mycobacterium tuberculosis culture (字2 =0.15, P ＞0.05). The study showed no statistical significance between the treatment effect and predicted effect by GeneXpert MTB/RIF Conclusion GeneXpert MTB/RIF system is of detecting and predicting value for pulmonary tuberculosis
patients with poor therapeutic effects. |
| Key words: GeneXpert MTB/RIF Rifampin resistant gene Mycobacterium tuberculosis |
